1. Chapter 13 Urinary System Diseases and Disorders

2. Anatomy and Physiology
Kidneys, ureters, bladder, and urethra
Kidneys are responsible for removing waste products from the bloodstream

3. Anatomy and Physiology
Ureters are tubules that run from kidney to bladder transporting urine
Bladder is a muscular organ that holds urine
Urethra carries urine to outside of body

4. Anatomy and Physiology
Urine is normally
Clear
Slightly yellow to gold
Free from sediments
Distinct odor but not foul smelling

5. Anatomy and Physiology
Urine is normally
Specific Gravity is to 1.030
pH is 6
Changes in these values indicate disease

6. Common Signs and Symptoms
Urinary Disease
Hematuria
Pyuria
Proteinuria
Dysuria

7. Common Signs and Symptoms
Urinary Disease
Nocturia
Oliguria
Anuria
Frequency/urgency

8. Diagnostic Tests Urinalysis Urine culture and sensitivity
Blood tests including BUN and creatinine clearance
IVP
KUB

9. Diagnostic Tests Cystogram Cystoscopy Bladder and kidney biopsy
Catheterization

10. Common Diseases of the Urinary Tract
Urinary Tract Infections (UTIs)
Broad diagnosis covering infections of urinary tract including the urethra, bladder, and kidneys
Caused by virus and fungi but most often are bacterial
Most common bacteria is escherichia coli (E.coli)

11. Common Diseases of the Urinary Tract
Affects females more frequently than males
Female urethra is shorter
Female urethral opening is closer to rectum
Improper female toilet habits

12. Common Diseases of the Urinary Tract
Affects females more frequently than males
Vaginal secretions may harbor bacteria
Sexual intercourse may cause trauma to urethra and bladder leading to inflammation and infection

13. Common Diseases of the Urinary Tract
Affects females more frequently than males
Pregnant females are more susceptible to infection due to pressure of uterus on urinary tract
Male prostatic secretions have antibacterial effect, reducing risk of UTI

14. Common Diseases of the Urinary Tract
Diagnosis by urinalysis and culture of urine specimen
Treatment is usually antibiotics

15. Common Diseases of the Urinary Tract
Urethritis
Inflammation of the urethra
More common in men
Commonly occurs with cystitis
Symptoms include swelling of the urethra, dysuria, and urethral discharge

16. Common Diseases of the Urinary Tract
Cystitis - Inflammation of the bladder
Commonly called “bladder infection”
Occurring in females as they become sexually active is “honeymoon cystitis”

17. Common Diseases of the Urinary Tract
Treatment is antibiotics
Antispasmodic medications such as Pyridium may decrease bladder spasms
May cause urine to turn reddish orange

18. Common Diseases of the Urinary Tract
Pyelitis - Inflammation of pelvis of the kidney
Result of ascending infection from bladder
Rapid diagnosis and treatment is imperative to prevent spread of infection

19. Common Diseases of the Urinary Tract
Pyelonephritis
May be due to an ascending or hematogenous infection and may affect one or both kidneys
Symptoms include sudden onset of fever and chills with flank pain and hematuria
Treated effectively with antibiotics

20. Common Diseases of the Kidney
Glomerulonephritis (Acute)
Inflammation of glomerulus or filtering unit of kidney
Most common disease of kidney
Occurs 1 to 4 weeks after strep infection

21. Common Diseases of the Kidney
Glomerulonephritis (Acute)
Symptoms
Flank pain
Fever
Loss of appetite

22. Common Diseases of the Kidney
Glomerulonephritis (Acute)
Symptoms
Malaise
Eyes and ankles are edematous
Oliguria
Hematuria

23. Common Diseases of the Kidney
Glomerulonephritis (Acute)
Treatment
Antipyretic
Diuretic
Salt restriction
Protein restrictions
Fluid restrictions

24. Common Diseases of the Kidney
Glomerulonephritis (chronic)
Repeated bouts lead to chronic condition
Symptoms include those of acute glomerulonephritis and hypertension
Uremia may occur during late stages
Treatment includes peritoneal or hemodialysis

25. Common Diseases of the Kidney
Hydronephrosis
Urine in renal pelvis due to obstruction causing dilation and distention of kidney pelvis
Diagnosis is confirmed by pyelogram
Treatment includes draining of kidney pelvis by surgery or relief of obstruction

26. Common Diseases of the Kidney
Renal Calculi
Called “kidney stones”
Form in pelvis of kidney
Symptoms are hematuria and renal or urinary colic and extreme spasmodic flank pain

27. Common Diseases of the Kidney
Renal Calculi
Diagnosis confirmed by IVP, KUB, renal ultrasound
Treatment is pain medication, increasing fluid intake, strain urine, surgery

28. Common Diseases of the Kidney
Polycystic Disease
Inherited disease causing enlargement of kidneys due to grape-like cysts
Symptoms
Lumbar pain
Hematuria
Recurrent UTIs

29. Common Diseases of the Kidney
Polycystic Disease
Treatment
Management of hypertension and UTIs
Dialysis and kidney transplant
Slow progressive disease and not curable

30. Common Diseases of the Kidney
Renal Failure
Failure of kidneys to cleanse blood of waste products
BUN and creatinine measure kidney function
Can be acute or chronic

31. Common Diseases of the Kidney
Renal Failure
Symptoms are not significant until 75 percent of kidney function is destroyed

32. Common Diseases of the Kidney
Renal Failure
Treatment
Management of cause of failure
Limiting sodium and protein
I & O

33. Common Diseases of the Kidney
Renal Failure
Treatment
Antihypertensives
Diuretics and antibiotics
Dialysis and transplant are long-term treatment

34. Common Diseases of the Kidney
Adenocarcinoma of the Kidney
Cigarette smoking is a risk factor
Frequently metastasizes to liver, brain, and bone before symptoms appear

35. Common Diseases of the Kidney
Adenocarcinoma of the Kidney
Symptoms include painless hematuria, flank pain, and fever
Diagnosis: KUB, IVP, CT, and biopsy
Treatment is nephrectomy, chemotherapy and radiation

36. Diseases of the Bladder
Urinary Incontinence - loss of urine flow control
Types of incontinence
Stress
Urge
Overflow

37. Diseases of the Bladder
Treatment of Incontinence
Empty bladder
Kegel’s exercises to strengthen pelvic muscles
Collagen injections near external sphincter to narrow the urethra
Marshall-Marchetti-Krantz procedure

38. Diseases of the Bladder
Transitional Cell Carcinoma of Bladder
Most common neoplasm of urinary tract arising from lining of bladder
Diagnosis: cystoscopy and biopsy
Treatment depends on stage of tumor, TUR, cystecomy

39. Trauma
Straddle Injuries
Neurogenic bladder

40. Rare Diseases Goodpasture’s Syndrome
Interstitial Cystitis - nonbacterial cystitis due to inflammation of inner lining of bladder

41. Effects of Aging on the System
Urinary incontinence
Prostatic hypertrophy (older males): dribbling, frequency, pain or burning, and difficulty starting urine flow